The present invention is particularly for use by people who are confined to bed for medical or other reasons, and most particularly for such people as are significantly immobile, and/or incontinent. The present disclosure concerns improvements to bedpan system apparatus and methods such as those previously disclosed by the present inventor, Sandra Stefano.
Anyone who has been confined to bed and has faced using a bedpan for defecation or urination while so confined, appreciates the embarrassment and discomfort associated with the use of a bedpan while bedridden. The discomfort is especially critical for patients whose condition requires them to remain nearly horizontal, not allowing the patient to be raised to approach a sitting position. In such situations, the elevation of the hips caused by a bedpan inserted between the patient and a flat supporting surface puts the patient into a position in which most find defecation nearly impossible. Little need be said of the personal discomfort that arises from sustained periods during which defecation is denied, not to mention the physiologic difficulties that may result, such as diverticulitis or impaction.
Prior art, especially that of the present inventor listed above, has provided an underlayment, which could be a mattress, for placing beneath a bedridden patient to elevate the patient above any underlying substantially horizontal support and, by means of a cavity in the underlayment, clearance is provided for the placement of a bedpan for use by the patient.
There is a particular need for bedpan systems that accommodate the special needs of patients who are bedridden for long periods of time, and/or are substantially immobile, and/or have especially sensitive or fragile skin (e.g., burn patients, elderly). In such cases the bedpan system must allow insertion and removal of the bedpan without requiring significant movement of the patient's hips or thighs, and without scraping, rubbing hard, or otherwise irritating or deleteriously affecting a patient's sensitive skin.
Another concern that is particularly heightened for such special needs bed patients is the surface of the underlayment. The underlayment must not present any rough or hard edges under the patient, and consequently any covering (e.g., a sheet) must also be as smooth and wrinkle-free as possible. Furthermore, while the underlayment must allow for cleaning and disinfecting, it should not be slippery. Preferably the material will also allow some “breathing” rather than causing the patient to sweat where in contact with the underlayment.
Finally, as a practical matter, it is desirable to provide sufficient space between the bedpan and the patient such that a caregiver can clean the patient without access being impeded by the bedpan, and without danger of the caregiver's hand being in contact with the contents of the used bedpan.
It is known from the inventor's previous patents to provide an inflatable mattress having a cavity below (in registry with) the buttocks of a supine patient lying on the mattress. This cavity accommodates a bedpan of common commercial use so that, owing to the low inflation pressure of the inflatable mattress, the surface of the mattress may easily be depressed, thereby to permit such bedpan of common commercial use to be inserted into—and subsequently removed from—the cavity without deleterious contact with the patient's skin, even if the patient's legs cannot be moved or raised.
It is also known to provide disposable bedpans that are flexible enough to be used in conjunction with a variety of patient underlayments with cavities including ones that are far more rigid than an inflatable mattress. These known disposable bedpans comprise bags formed of flexible plastic sheeting plus some means of holding the bag open for use as a bedpan. After use, if the bag can be collapsed it is then pulled out between the patient's legs (and/or under the legs if the mattress is flexible enough to depress).
U.S. Pat. No. 6,725,485 (Hayes; 2004) discloses a bedpan system embodiment using a wastebag (50) as the human waste receptacle. In this embodiment, a support ring (53-55) mates with the cavity (17) under spring tension. One portion of the support ring (54) is supported on the top surface of the mattress, another portion (55) extends into the cavity, and a third portion (53) completes the support ring (53-55). The wastebag is secured to the ring by means of an elastic material (51). To facilitate the placement and removal of the support ring (53-55) into the cavity, a handle (56) extends from the support ring and acts like a spring so as to be under tension when the end of the handle (52) engages the cavity (17). Hayes also discloses various means for filling the cavity when not housing a bedpan: a controllable expandable (inflatable) cushion (16), or a full size cavity plug (17′, FIG. 10). Disclosed bed coverings include a bed sheet (30) with a slit over the cavity that is closed by a flap or fly (31, FIG. 7-8), or a conventional bed sheet (30) and underpad (33) that are gathered into the cavity (FIG. 15-16).
Apparent limitations: Hayes' support ring portion (54) that rests on the top surface of the mattress could be irritating if left in place, and the support ring (53-55 as seen in Hayes' FIG. 17) appears to be a formed wire, multilevel metal structure that may be difficult to move past the patient's legs if they can't be lifted. Hayes' full size cavity plug would be very difficult to remove when a patient is present. As can be seen in Hayes' FIGS. 7, 8, 15, and 16, his bed coverings all present potentially irritating wrinkles or ridges that would be under a supine patient. Furthermore, the edges of a slit would have to be dragged under an immobile patient's buttocks in order to spread it open to reveal the cavity.
U.S. Pat. No. 4,011,610 (Parker, III; 1977) discloses a bedpan system in which a mattress has an opening to accept a bedpan assembly (42, 44), the bedpan (42) being provided with a disposable liner/bag (46) to fully cover the surfaces engaged during usage (bedpan seat 44) and with the mouth of the liner being trapped between the bedpan (42) and the mattress, with a sheet having a central aperture and a cuff (40) to line and protect the aperture in the mattress, the cuff (40) being trapped between the mattress and the bedpan (42), with a mattress plug (26) to resiliently cover the bedpan (40) when not in use and provide a rigid supporting base (70) to center the plug, and an anti-contamination supporting plate (80) underlying the mattress and the bedpan (40), and serving to control the position of the bedpan (400) relative to the springs and mattress. A covering sheet (48) may be tied or otherwise secured upon the mattress plug.
It is apparent that while Parker's disposable bag can be removed without significantly disturbing the patient, the same cannot be said for the bedpan that therefore is intended to be left in place as a support for the mattress plug. Apparent limitations include a complex mattress design including difficult to clean recesses, a bedpan that may need to be removed in order to clean it if needed, and a cavity that isn't fully enclosed—therefore being difficult to de-contaminate in the event of spills. The plug appears to be rather bulky and therefore difficult to insert/remove under a patient. Finally, it is not apparent how a new disposable bag can be easily deployed on the bedpan when an immobile patient is lying over it.
U.S. Pat. No. 6,000,078 (Stefano; 1999) discloses a disposable bedpan system for use with a patient underlayment (40) that has a cavity (42) in registry with the buttocks of a supine patient lying thereon. The disposable bedpan (20) is supported in said cavity by a laterally-collapsible hoop-like support (30). In the best mode, the hoop-like support has fulcrum extensions (36) to provide support for the underlayment. Markings (26) on the disposable bedpan (20) provide a tool to measure the volume of waste from the patient. A padded plug (70) that fills the space between the hoop-like support and the top of the underlayment provides comfort for the patient while the bedpan (20) is installed but not in use.
U.S. Pat. No. 6,243,898 (Ruff; 2001) discloses a mattress having a centrally located cut-out portion that has an insert (50) that fits therein. The combination of the mattress and insert provides a flat surface on which a bedridden person can lie. The insert is removable from the cut-out portion so that a bed pan may be placed therein. A first fitted sheet (70) surrounds the mattress and extends within the cut-out portion, while a second fitted sheet (80) surrounds the insert. In combination, the first and second fitted sheets provide a sanitary covering to the mattress and insert that can easily be replaced, but one that will not come loose merely from the movement of the person on the mattress. The first fitted sheet is secured about the bottom of the mattress by means including elastic bands (72) as on conventional fitted sheets, especially those for a water bed mattress. The first fitted sheet may either extend within cut-out portion (40) and completely cover the inner surfaces of the cut-out portion, including the sides (44) and floor (46), as shown in Ruff's FIG. 2, or first fitted sheet may be designed to extend down the inner sides of cut-out portion, as shown in Ruff's FIG. 1. In either case, the first fitted sheet performs its function to cover those areas of mattress (20) that would be in contact with a person lying on the bed. Furthermore, by extending the first fitted sheet within the cut-out portion the first fitted sheet is thereby secured about the perimeter of the cut-out portion, so that the mattress will not readily be uncovered. The second fitted sheet (80) surrounds insert (50) by grabbing its bottom edges (56) with preferably an elastic band (82), much the same way as the first fitted sheet is secured about the mattress.
Although Ruff's first fitted sheet may be held wrinkle free, it appears that the second fitted sheet is not well enough secured by its elastic bands, and furthermore does not provide a convenient way to grasp and pull out the insert when a patient is lying thereupon.
The foregoing illustrates limitations known to exist in prior art devices and methods. Thus, it is apparent that it would be advantageous to provide an alternative directed to overcoming one or more of the limitations set forth above. Accordingly, a suitable alternative is provided including features more fully disclosed hereinafter.